title: Effect of stress and bupropion on craving, withdrawal symptoms, and mood in smokers.
abstract: BACKGROUND
  Studies suggest that in smokers attempting to quit smoking, the occurrence of stressful events is associated with smoking relapse. The purpose of this study was to determine the effect of bupropion (an agent known to increase smoking cessation rates) on the craving, withdrawal, and mood response to stressful tasks administered in a laboratory setting.
  
  
  METHODS
  Response to three tasks (a speech, math, and cold pressor task) was measured in 65 smokers during ad libitum smoking. Smokers were then randomized to either bupropion or placebo. Fourteen days after starting medication, 43 subjects (28 receiving bupropion and 15 receiving placebo) quit smoking and laboratory procedures were repeated on the third day of abstinence.
  
  
  RESULTS
  Prior to cessation, stressors presented in a laboratory setting increased craving, nicotine withdrawal symptoms, and subjective distress but decreased positive affect. Thirty minutes of relaxation after the stressors did not result in these measures returning to prestress levels. During the nicotine withdrawal period, stress-induced responses were generally smaller than during the precessation period. Bupropion (relative to placebo) reduced overall levels of craving and withdrawal symptoms but did not have significant effects on response to stress during the nicotine withdrawal period.
  
  
  CONCLUSIONS
  This study demonstrates that stress results in sustained increases in craving and withdrawal symptoms and changes in mood symptoms and that bupropion affects overall levels of these symptoms. Further research is needed to determine if modifying response to stress is predictive of an effective treatment for facilitating smoking cessation.
authors.affiliation: Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 7-170 Weaver Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA. kotly001@umn.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Kotlyar
authors.forename: David
authors.initials: D
authors.lastname: Drone
authors.forename: Paul
authors.initials: P
authors.lastname: Thuras
authors.forename: Dorothy K
authors.initials: DK
authors.lastname: Hatsukami
authors.forename: Lisa
authors.initials: L
authors.lastname: Brauer
authors.forename: David E
authors.initials: DE
authors.lastname: Adson
authors.forename: Mustafa
authors.initials: M
authors.lastname: al'Absi
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect / Q000187:drug effects*; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D016642:Bupropion / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016540:Smoking Cessation / Q000379:methods*; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy* / Q000517:prevention & control / Q000523:psychology; D014029:Tobacco Use Disorder / Q000188:drug therapy / Q000517:prevention & control; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018687:Antidepressive Agents, Second-Generation; D016642:Bupropion